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Individual

CHARLES EDWARD HOLTZ JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
1599 J ST, GRAND FORKS AFB, ND 58205-6306
(701) 747-5504
(701) 747-5923
Mailing address
2026 SPRUCE DR, UNIT A, GRAND FORKS, ND 58204-1864
(701) 747-5504
(701) 747-5923

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
05/13/2009
Last updated
05/13/2009
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